NPI | 1285962886 |
---|---|
Entity Type | Organization |
Authorized Contact | CARLISSA Y GOODWIN Care Provider 803-735-9680 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 101ym0800x) |
Enumeration Date | 2009-11-20 |
Last Update Date | 2009-11-20 |